Laparoscopic surgery for gastric cancer: a systematic review

The objective of this paper is to systematically review current literature on laparoscopic surgery for gastric cancer in terms of current indications and feasibility as well as short-term and long-term postoperative outcomes.

A systematic review was conducted with respect to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines using PubMed and is up-to-date until January 1, 2014.

A total of 99 papers matched the inclusion criteria and comprised of 92 case-control studies and 7 randomized controlled trials (RCTs). The majority of these papers focused on short-term outcomes of laparoscopy-assisted distal gastrectomy (LADG), which are superior compared to open distal gastrectomy (ODG). Lymphadenectomy extent, morbidity, and mortality rates as well as disease-free and overall survival did not differ significantly between LADG and ODG groups. Finally, the implementation of laparoscopic gastrectomy was assessed in advanced gastric carcinoma, obese, and elderly patients.

This systematic review revealed that laparoscopic surgery is safe and effective for the treatment of gastric cancer. LADG offers better short-term and similar long-term results to ODG. Well-designed multicenter RCTs are needed to better understand the limitations of oncologic laparoscopic gastrectomy.